Locum Tenens Blog

The Scope of VA Healthcare: Hiring Doctors Isn’t Easy

The VA (U.S. Department of Veterans Affairs) provides much needed healthcare services to those who have served our country. Their mission statement: “To fulfill President Lincoln’s promise ‘To care for him who shall have borne the battle, and for his widow, and his orphan’ by serving and honoring the men and women who are America’s veterans.”

Unfortunately, it is far too common for veterans to end up on waitlists that lead to weeks or months of waiting time before seeing a doctor. Like other healthcare organizations, VA facilities are dealing with staffing shortages, which are often linked to the long wait times.

Bottom line: it is not easy for the VA to hire new doctors. This is not just due to budget constraints; the fact is that, whether right or wrong, many doctors have trepidation when it comes to working at VA facilities. Without identifying feasible solutions, the VA may continue to struggle in it’s battle to provide health care for the increasing number of veterans relying on their services.

Lack of Interest

A 2015 survey from The Medicus Firm found that only 4 percent of healthcare providers would actually wish to work in military or government-employed practice. Although this was an increase from 2014 (2.5%), the study reveals that it is still common for physicians to prefer private healthcare facilities and hospitals rather than in VA facilities. The lack of interest is a major impediment to the VA finding the doctors needed to handle the increasing demands of veterans.

Lack of Funds

Funding is another large component of the VA’s healthcare problems. Many veterans rely on VA facilities for numerous healthcare concerns beyond just treatment for issues related to their military service, increasing the demand on the facilities. There has also been an increase in the number of veterans. The number of veterans increased 141% between 1996 and 2003, resulting in an influx of VA patients. However, the facilities did not get nearly enough funding to handle it, with less than 60% increase in the budget.

Congress has responded and is working on providing funding for additional staff in the VA facilities. However, along with additional funds the VA also needs to attract doctors who actually want to take the jobs. With a general staffing shortage around the country, doctors can typically go where they want to for jobs.

Locum Tenens to the Rescue?

Locum tenens provides one solution for the VA. Doctors and other medical professionals can come into VA facilities during busy periods and help patients get the care they need. Already, many VA facilities depend on locum tenens medical staff to make up the staffing shortages. Many of the VA jobs are tough, requiring long hours in rural areas for less pay than private facilities. Locum tenens allows physicians to practice and then leave before they get burned out.

Although this provides a solution, it also has the potential to negatively impact aspects of care, such as continuity of care and communication, if there is not the right structure in place to create oversight.

What About the Full Practice Authority Rule for NPs?

Another potential solution is currently being debated. The Department of Veteran Affairs proposed to allow nurse practitioners full practice authorityin VA facilities, no matter in which state. This would give NPs the ability to practice without oversight from physicians, even in the states that require supervision by physicians, such as Texas, Georgia, and Florida.

Many studies have found that NPs have sufficient knowledge, education, and experience to provide safe and effective healthcare. The VA hopes that this would help veterans get access to the high-quality health care they deserve and provide more efficient use of the VA resources. However, the American Medical Association opposes the proposal and has expressed the following:

“The American Medical Association (AMA) is disappointed by the Department of Veterans Affairs’ (VA) unprecedented proposal to allow advanced practice nurses (APRN) within the VA to practice independently of a physician’s clinical oversight, regardless of individual state law. With over 10,000 hours of education and training, physicians bring tremendous value to the healthcare team. All patients deserve access to physician expertise, whether for primary care, chronic health management, anesthesia, or pain medicine.”

Nurse Practitioners have the potential to greatly reduce staffing shortages.

As the argument continues, it appears as though the VA plans to continue its plan to bring in NPs. There is also the potential to increase their staff numbers with locum tenens nurse practitioners until they can attract more permanent staff, whether physicians or NPs.

There are many strategies that the VA could use to help solve its physician shortages and start to offer the quality of care that veterans deserve. A new structure, more funding, NPs, locum tenens physicians and other options can work together to rebuild the broken system and create one that is effective and up to date for the needs of the modern era.